CALL 417-865-8812

Long Term Care Claims Process for Home Health and Private Duty Home Care

Many long term care insurance policies provide reimbursement for home-based services such as home health and private duty home care. The amount of reimbursement for home health and home care services varies based on the policy you have but typically ranges from 3 to 8 hours of care per day. Some policies provide for more care depending on the policy and patient needs. Many long term care policies require that the patient needs assistance with at least three ADL’s (activities of daily living) in order to qualify as well as a waiting period. Qualifying ADL’s can be things like; eating, bathing, getting dressed, toileting, transferring, driving, etc. The waiting period associated with a long term care policy is often viewed like a deductible, where the patient must pay out of pocket for home care services for a specified period of time (usually 30-90 days) before qualifying reimbursement under the policy will kick in.


Sutton In-Home Senior Care accepts most long term care policies. Long term care policies have a variety of claims processes, waiting periods, predefined triggers for care, etc. Our agency works with long term care insurance companies and our clients throughout the claims process to ensure the policy holder is receiving the care they need. Claims benefits vary from company to company and policy to policy. Call us today and we can help jump start the claims process for you or your loved one. This is what we do and we want to help in any way we can.


There are a number of companies that sell long-term care policies, also known as LTC policies or LTCI policies. Below is a list of long-term care policy providers that we have worked with:


  • • State Farm
  • • New York Life
  • • Mutual of Omaha
  • • MetLife
  • • Thrivent
  • • Washington National
  • • UNUM
  • • Prudential
  • • Lincoln Financial
  • • John Handcock
  • • Genworth
  • • SHIP


***If you do not see your long-term insurance carrier on this list, please call the office. There are many companies that sell long-term care policies. If your insurance company is not on this list, we will take the steps necessary to help get your claim processed. 417-865-8812